Prognostic factors for poor survival after repeat hepatectomy in patients with colorectal liver metastases.

Abstract:

BACKGROUND:The recurrence rate for colorectal liver metastases after repeat hepatic resection is high, and selection criteria for repeat hepatectomy are still controversial. METHODS:Clinical data of patients undergoing repeat hepatectomy for metastatic colon cancer were reviewed retrospectively and compared with those of initial hepatectomy and other treatments to determine criteria for repeat hepatectomy and to confirm its efficacy. RESULTS:For 22 patients who underwent repeat hepatectomy, no mortality and an 18% morbidity rate were observed. The 3-year survival rate after repeat hepatectomy was 49%. The only poor prognostic factor after repeat hepatectomy was a serum carcinoembryonic antigen level greater than 50 ng/mL before initial hepatectomy. The prognosis for patients who underwent repeat hepatectomy and had shown high carcinoembryonic antigen levels before initial hepatectomy was approximately equal to that for the patients who received systemic chemotherapy or hepatic arterial infusion for unresectable tumors in the remnant liver. CONCLUSION:Repeat hepatectomy for colorectal liver metastases can be performed safely and appears to be as effective as initial hepatectomy. However, for patients with a carcinoembryonic antigen level greater than 50 ng/mL before the initial hepatectomy, repeat hepatic resection alone may not be as effective, and a new strategy is needed.

journal_name

Surgery

journal_title

Surgery

authors

Takahashi S,Inoue K,Konishi M,Nakagouri T,Kinoshita T

doi

10.1067/msy.2003.151

subject

Has Abstract

pub_date

2003-06-01 00:00:00

pages

627-34

issue

6

eissn

0039-6060

issn

1532-7361

pii

S0039606003000734

journal_volume

133

pub_type

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